乳腺纤维腺瘤与分叶状肿瘤超声表现的对照分析

Comparative Analysis of Breast Fibroadenoma and Phyllodes Tumor Ultrasound Manifestations

目的:探讨乳腺纤维腺瘤与分叶状肿瘤的超声声像图表现及其鉴别特点,为提高乳腺病变的影像学诊断效果提供指导。方法:收集经病理证实的乳腺纤维腺瘤(n=86例)、乳腺分叶状肿瘤(21例)患者临床资料、二维声像图表现及其彩色多普勒血流信息,比较两种乳腺病变超声表现的异同点并加以统计学分析。结果:乳腺纤维腺瘤肿块最大径(20.14±8.71)mm,病灶边界尚清、形态以较为规则的椭圆形多见,多普勒频谱为低阻型,血流信号0~Ⅰ级级者占68.6%,内部回声多数均匀,病灶内部稍低回声至等回声,后方少数回声增强,肿瘤内部钙化灶少见,囊性变无检出;分叶状肿瘤肿块最大径(32.59±10.49)mm,边界较清晰,边缘多呈分叶状,内部回声不均者居多,可见条状高回声分隔,血流信号Ⅱ~Ⅲ级级者占61.9%,病灶内较少囊性变及钙化灶。与分叶状肿瘤相比,乳腺纤维腺瘤病灶最大径平均值、肿瘤囊性变检出率及边缘呈分叶状者均显著减少(P<0.05),内部回声均匀及血流信号少的检查率(0~Ⅰ级)则升高(P<0.05),二者在病灶纵横比、腋窝淋巴结变化、内部钙化灶检出率、Vmax及RI指数的差异性方面,统计学意义不显著(P>0.05)。结论:彩色多普勒超声在乳腺纤维腺瘤和分叶状肿瘤的预测中具有部分特异性指标,但二者的超声表现亦存在一定重合性,临床中须注意从更多角度加以判断、定性。

Objective:To explore the ultrasonographic features and characteristics of breast fibroadenoma and lobular tumor,to provide guidance for the imaging diagnosis of breast lesions.Methods:Pathologically proved breast fibroadenoma(n=86 cases),phyllodes tumor(21 cases)of patients with clinical data,2-D ultrasound and color Doppler flow information were collected.The differences and similarities of ultrasonic manifestations of two kinds of breast lesions were compared and analyzed statistically.Results:The maximum diameter of the breast fibroadenoma was(20.14+8.71)mm.The boundary of the lesion was clear and the shape was more regular in the oval shape and the Doppler spectrum was a low resistance type.The blood flow signal 0~grade I was 68.6%.The internal echo was most homogeneous,the internal echo of the lesion was slightly hypoechoic to equal echo,a few echoes in the rear were enhanced,the calcification in the tumor was rare,and the cystic degeneration was not detected.Phyllodes tumor of the largest tumor diameter was(32.59+10.49)mm.The boundary was clear,lobulated edge and many of the internal echo unevenly,visible high echo separation.The blood flow signal II^III grade accounted for 61.9%.There were fewer cystic changes and calcification in the lesion.Compared with phyllodes tumor of breast fibroadenoma,the maximum diameter of the lesions,the average detection rate and tumor cystic degeneration were lobulated were significantly reduced(P<0.05),internal echo and blood flow signal less uniform examination rate(0~grade)was increased(P<0.05).There was no statistically significant difference in the aspect ratio,axillary lymph node change,calcification detection rate,Vmax and RI index between the two groups(P>0.05).Conclusion:Color Doppler ultrasound is part of a specific index in the prediction of breast fibroadenoma and phyllodes tumors,but the ultrasound findings of two there is also a certain coincidence,clinical qualitative judgment,must pay attention from more angles.